Failure to Thrive

I'm looking for input from anyone who may have experienced what I'm going through right now with my son. He's 18 mos. old and is 22 lbs. He hasn't really gained weight for the last 5 months and our pediatrician is concerned. He has food allergies (milk, eggs, nuts). I'm still nursing him and he doesn't appear to be ready to wean yet, which I am fine with. He's taking Cytra-3 because he had low co2 levels and they are back to normal now. We saw a nutritionist who said he's fine...no need to worry. The next day we had a GI consult and they said it's failure to thrive. They tested his stool and said that there's no evidence of malnourishment, but they want me to stop breastfeeding immediately and start feeding him higher fat foods. I'm worried sick and am having a hard time with 2 completely different diagnosis. I can do the fatty foods, but he went on a liquid strike when I tried to stop nursing and I'm guessing that breastmilk is better than dehydration. He will drink water from a sippy cup, but he's not impressed with soy milk. Any thoughts? Advice??

This reminds me of what another doctor said. My son has had some unrelated issues and had to have xrays. The xrays looked bad, but he was doing well. They said "treat the patient not the xray". In other words, gear your treatment to the individual and their quality of life not a number or an xray or a test result. Kinda makes sense.

I would keep nursing him. It seems rather counterintuitive to take away the only food source he is definitely eating. After you do that, then what? He starves himself until he gives in? At least with nursing, he is getting nutrients and calories direct from you, in addition to immunity properties.

I like how they said they didn't find evidence of malnourishment but then tell you to stop nursing him. What a hoot!

Try giving him nutrient/calorie dense foods and then nursing. For example, you could slice a fresh avacado and offer him pieces and then nurse.

But take away his life line? Especially with allergies? No way! That's about as ridiculous as when doctors clamp the cord immediately after birth so they can carry the baby away to rescusitate. Can we say DUH.

I think that as a mom-you know best! Feed him breastmilk if you want to and he likes it. He can get fats many other places!! If his stool is not testing positive for malnurishment--then there is definitely something else going on! I am not a doctor, but I might as well be with all the research I do online after I have been misdiagnosed, had lab results mixed up a few times now etc... Seriously--doctors in my town (Vegas) are for the most part, not very good. But I do have to thank them for making me a very proactive patient!! I would definitely look up a Dr. in your area on RateMds.com It is awesome as well as Angies List. Obviously some people are just angry at doctors and have to vent, but the sites are very well maintained for doctors to give their response if the post is invalid. A good doctor should be able to give you multiple food options and I hate to say this but more often than not your child may not be actually allergic to all those foods--milk and nuts together is not common to be allergic to. I support you--keep in touch! ;) Sarah

One thing comes to mind that maybe try putting out a "nibble tray" on the table so while he is playing, he can come over and snack on healthy foods such as avocado pieces, cooked vegetables with organic butter or coconut on them, raw vegetables, popcorn with olive oil or coconut oil, high quality non-nitrate lunch meat/turkey pieces, banana slices etc. Many times children at that age are too busy to sit and eat so the nibble tray gives them the freedom to play and still snack at the same time. Our pediatrician, Dr. William Sears, recommends the snack tray for toddlers who are too busy to sit down and eat. He recommends foods like hard boiled eggs, nuts, fruits and vegetables, peanut butter, yogurt for dipping etc but since your son has milk, egg and nut allergies, you can just modify the foods you put on the tray.

The pediatrician is wrong about the breastfeeding part. I wouldn't stop breastfeeding because there isn't more of nutrition dense complete food for your toddler than breastfeeding. Breastfeeding is the most important part of his diet and stopping that could lead to even lower weight.

Reija, what a good point! I do this for DD during the afternoon b/c she will forget to nurse and get really cranky. I just set out some organic crackers, pieces of fruit, popcorn, carrot sticks, raw broccoli, etc. Basically what works for us (I know fruit w/ other food isn't great for digestion, but she loves a couple apple slices so I haven't pushed the issue).

What a difficult situation! I urge you to please please please continue breastfeeding- the nutrition in your breastmilk is far more bioavailable to your son, and is so much more important considering the food allergies. On what basis did the GI doc make his diagnosis? It sounds unfounded to me. Anecdotally, my daughter was 18 pounds by about 8 months, 19 pounds at a year, and didn't gain until after she was 18 months old- but she got mobile. She was sustaining her weight, and gaining height. Is your son alert, energetic, contented? Is his urine clear/pale, and does he have regular bowel movements (and I mean regular for him)? All of these things would change if there were something wrong. Also, is he still growing on some sort of curve? All children grow at their own rate, and grow, and plateau, and grow, and plateau. I'd put more faith in the nutritionist and your instinct. Best wishes!

My youngest daughter was a "failure to thrive" baby, too. This all sounds so familiar! She has Turner's Syndrome, which caused growth delays. I too was told that my breastfeeding was the cause of her low weight gain. I did not stop. I will say, though, that I had to make her eat by withholding nursing until she ate. That wasn't fun. That was 22 years ago. Some things never change... I'm glad you have support here, wish I had.

I would not stress out too much. You probably need to go to another GI specialist for a secondary consult or even another pediatrician. Sounds like this guy is just jumping the gun. To add, 18 months and 22 lbs is not really that big a deal. I have 2 kids that were both that size at 18 months. I think they were -5-10% on the american growth chart. however, as long as they are eating well and their head circumference is still growing and they are reaching most of their milestones, it should be fine. I personally feel that the whole american standards for growth are skewed. With his allergies, you definately have some challenges. I am sure the breastfeeding is helping him as a supplement to regular meals. Also, have you done much research on "failure to thrive?" I thought that there had to be some developmental delays along with it...not just weight.

I have read some very interesting information that may be important to you regarding soy products. There can be some issues with boys and high soy intake due to the estrogen in soy. If it was me I would do some research on this topic before using soy as an alternative. Search 'soy' on mercola.com

Hi,
You need to talk to my daughter-in law who I feel is an expert with all of the concerns with breast feeding etc. she has seen it all. Her e-mail address is: nhirsch@myhealthybeginning.com. She has a magazine that helps all. Goof luck to you.
Blessings,
Jackie

Honestly, I wouldn't panic. My son will be 5 in a couple weeks and he's only around 3'3" and 35 lbs (somewhere around the third percentile now). He's been to his Doctor repeatedly, been tested for allergies, tested his thyroid, we constantly ask if he's underweight. There's never been any huge panic about his size. Many boys in his Kindergarten are within 1-2 inches and around the same weight too.

Kids come in all shapes and sizes and so many of the graphs they use to chart height are inaccurate, holdovers from a time when formula feeding was the norm which tended to produce heavier babies than breastfeeding. And I think too with all the rampant child obesity, even Doctors are just expecting that every baby will have rolls upon rolls. Some children are just small and thin and not all children love to eat or have large appetites. My son has never liked eating, even as a baby. Even the things he likes, he'll have three or four bites and then be done with it. It doesn't always mean malnourished or a health issue.

As long as your child is healthy overall, they may just be growing more slowly than their peers. They may have a growth spurt yet or just continue to grow slowly all their life. My male friend never had a growth spurt and he's 6'3" and 300 lbs. You just can't predict these things.